Highlights
- •Characterized Achilles and patellar tendon loading with shear wave tensiometry.
- •Triceps surae exhibits spring-like behavior in crouch gait due to cerebral palsy.
- •Quadriceps exhibit motor-like, positive work in crouch due to cerebral palsy.
- •Redistribution in work relevant for treatment planning to correct crouch.
Abstract
Background
Previous study showed the triceps surae exhibits spring-like behavior about the ankle
during walking in children with cerebral palsy. Thus, the work generated by the triceps
surae is diminished relative to typically developing children. This study investigated
whether the quadriceps offset the lack of triceps surae work production in children
with cerebral palsy who walk in crouch.
Methods
Seven children with cerebral palsy (8-16 yrs) and 14 typically developing controls
(8-17 yrs) walked overground at their preferred speed in a motion analysis laboratory.
Shear wave tensiometers were used to track patellar and Achilles tendon loading throughout
the gait cycle. Tendon force measures were coupled with muscle-tendon kinematic estimates
to characterize the net work generated by the quadriceps and triceps surae about the
knee and ankle, respectively.
Findings
Children with cerebral palsy generated significantly less triceps surae work when
compared to controls (P < 0.001). The reverse was true at the knee. Children with cerebral palsy generated
positive net work from the quadriceps about the knee, which exceeded the net quadriceps
work generated by controls (P = 0.028).
Interpretation
There was a marked difference in functional behavior of the triceps surae and quadriceps
in children with cerebral palsy who walk in crouch. In particular, the triceps surae
of children with cerebral palsy exhibited spring-like behavior about the ankle while
the quadriceps exhibited more motor-like behavior about the knee. This redistribution
in work could partly be associated with the elevated energetic cost of walking in
children with cerebral palsy and is relevant to consider when planning treatments
to correct crouch gait.
Keywords
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Article info
Publication history
Published online: January 03, 2023
Accepted:
January 2,
2023
Received:
August 10,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
